Clinical «masks» of somatoform disorders of the cardiorespiratory system and pain and non-specific somatoform disorders in children associated with affective states

Abstract

The aim of the study is to investigate the features of clinical manifestations of somatoform disorders (SD) by the cardiorespiratory system (CRS) and pain and nonspecific SD (PNSD), as well as their relationship with affective conditions in adolescent children.
Materials and methods. 48 children with SD from the CRS and 41 children with SD from the PNSD were examined. The mean age of children was 14.1±4.72 years (M±ρ), of which boys were 52.8% (n=47), girls — 47.2% (n=42). Spielberger test was used to investigate anxiety. The Child Depression Questionnaire M. Kovacs (1992) was used to diagnose depression. The probability was evaluated using the Student's t-test.
Results. SD was most commonly found in boys (58.3%) (p<0.039), mainly in rural areas (62.5%) (p<0.01). Most commonly, SD in boys manifested a transient increase in blood pressure (100%), headache (75%), and palpitations with a predominance of tachycardia (75%), whereas girls had a significantly higher incidence of fatigue (71.4%) and hypotension with syncope. states (57.1%) (p<0.05). Depression was reported in 29.2% of children with SD and 87.5% of children showed clinically expressed anxiety. PNSD was mainly affected by children of early adolescence — 23 (56.1%), who most often showed nonspecific persistent pain syndromes (82.9%) (headache, joint pain, fibromyalgia syndrome, back pain, etc.); disorders (43.9%) and asthenic syndrome (34.2%). In patients with PNSD, 48.8% of children were diagnosed with depression and 95.1% had anxiety.
Conclusions. Depressive disorders as well as anxiety disorders can be one of the key factors for the occurrence of SD in children and manifest themselves in a variety of somatic masks in the form of functional disorders of organs and systems, persistent pain syndromes, complicating the diagnosis and effectiveness of treatment. Anhedonia (64.3% and 65.0%, respectively) was the most frequent manifestation of depression in patients SD with CRS and PNSD. Less often, the key symptom of depression was low mood (7.1% and 5.0%, respectively).
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of an institution. The informed consent of the patients was obtained for conducting the studies.